Near‐infrared spectroscopy during exercise and recovery in children with juvenile dermatomyositis

Habers, G. Esther A.; Knikker, R de; Brussel, Marco van; Hulzebos, Erik H.J.; Stegeman, Dick F.; Royen, Annet van; Takken, Tim

doi:10.1002/mus.23484

Cited by 13 publications

(20 citation statements)

References 31 publications

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“…The measurements were performed according to a previously used protocol in our exercise laboratory (Habers et al . ). The probes of a single distance continuous wave photometer with two channels (OXYMON; Artinis, Zetten, The Netherlands) were fixed on the vastus medialis of the dominant leg of the participant.…”

Section: Methodsmentioning

confidence: 97%

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Exercise oxidative skeletal muscle metabolism in adolescents with cystic fibrosis

Werkman

Jeneson

Helders

et al. 2016

Experimental Physiology

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Introduction Patients with Cystic Fibrosis (CF) are reported to have limited exercise capacity. There is no consensus about a possible abnormality in skeletal muscle oxidative metabolism in CF. Our aim is to test the hypothesis that abnormalities in oxygenation and/or muscle oxidative metabolism contribute to exercise intolerance in adolescents with mild CF. Methods Ten adolescents with CF (12–18 years of age, FEV1>80%pred, resting oxygen saturation > 94%) and ten healthy age-matched controls (HC) were tested with supine cycle ergometry using near-infrared spectroscopy (NIRS) and 31Phosphorus magnetic resonance spectroscopy (31P MRS) to study skeletal muscle oxygenation and oxidative metabolism during rest, exercise and recovery. Results No statistically significant (p>0.1) differences in peak workload and peak oxygen uptake per kilogram lean body mass were found between CF and HC. No differences were found between CF and HC in bulk changes of quadriceps phosphocreatine (PCr) (p = .550) and inorganic phosphate (Pi) (p = .896) content and pH (p = .512) during symptom limited exercise. Furthermore, we found statistically identical kinetics for PCr resynthesis during recovery for CF and HC (p = .53). No statistically significant difference in peak exercise arbitrary unit for total haemoglobin content (tHb_AU) was found between CF and HC (p = .66). Discussion The results of this study provide evidence that in patients with mild CF and a stable clinical status (without signs of systemic inflammation and/or chronic PA colonisation), no intrinsic metabolic constraints and/or abnormalities in oxygenation and/or muscle oxidative metabolism contribute to exercise intolerance.

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Section: Methodsmentioning

confidence: 97%

“…), as described by Habers et al . (), to allow comparisons between groups. This normalization procedure involved averaging the values of Δ[O 2 Hb], Δ[HHb] and Δ[tHb] over the last 30 s of the resting period before exercise and assigning them a value of 0 a.u.…”

Section: Methodsmentioning

confidence: 99%

Exercise oxidative skeletal muscle metabolism in adolescents with cystic fibrosis

Werkman

Jeneson

Helders

et al. 2016

Experimental Physiology

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“…All studies evaluating exercise durations >3 weeks included creatine phosphokinase (CK) levels as a proxy measure of disease activity, all demonstrating unchanged or reduced levels of CK following exercise. Sixteen studies also investigated the effects of exercise on disease activity and muscle inflammation, metabolism and characteristics (Table ).…”

Section: Exercise Studies In Patients With Iimsmentioning

confidence: 99%

“…A majority of studies included patients with adult PM and DM (n = 22) [7][8][9][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], while a few focused on IBM (n = 6) [30][31][32][33][34][35] and JDM (n = 3) [36][37][38]. A small number of studies have also evaluated the feasibility of a single exercise test or exercise bout in patients with JDM [39][40][41][42]. The vast majority of studies have evaluated exercise in patients with noninflammatory active established disease [7, 8, 11, 13-15, 17-23, 25, 27-38], whereas patients with recent-onset, inflammatory active disease were included in only six studies [9,12,16,18,24,26].…”

Section: Exercise Studies In Patients With Iimsmentioning

confidence: 99%

“…[31] analysed muscle biopsies from seven patients with IBM following a 12-week home exercise programme and reported no change in capillary diameter, but a significant decrease in capillary density; the authors speculated that this could be due to a trend towards increased cross-sectional area. Habers et al [42] studied the change in balance between oxygen delivery and oxygen consumption as well as blood volume using near-infrared spectroscopy in the vastus medialis and lateralis in children with JDM or juvenile idiopathic arthritis (JIA) and in healthy control subjects before and after an incremental all-out cycle ergometer test [42]. Children with JDM had significantly reduced blood volume in the vastus medialis compared to control subjects, but not compared to children with JIA, while there was no difference in the oxygen delivery/consumption balance between groups [42].…”

Section: Effects Of Exercise In Adults and Children With Iimmentioning

confidence: 99%

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Physical exercise as a treatment for adult and juvenile myositis

Alexanderson

2016

J Intern Med

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Abstract. Alexanderson H (Karolinska Institutet, Huddinge, Stockholm; and Karolinska University Hospital, Solna, Stockholm, Sweden). Physical exercise as a treatment for adult and juvenile myositis (Review Symposium). J Intern Med 2016; 280: 75-96.There is growing evidence to support the safety and efficacy of exercise in patients with adult and juvenile idiopathic inflammatory myopathies. Five randomized controlled trials including adult patients with polymyositis and dermatomyositis (DM) and additional open studies have demonstrated reduced impairment and activity limitation as well as improved quality of life. In addition, recent studies have shown reduced disease activity assessed by consensus disease activity measures and reduced expression of genes regulating inflammation and fibrosis.Furthermore, exercise could improve muscle aerobic capacity as shown by increased mitochondrial enzyme activity. These data suggest that intensive aerobic exercise and resistance training could reduce disease activity and inflammation and improve muscle metabolism. Encouraging results have been reported from available open studies including patients with inclusion body myositis (IBM) and juvenile DM, indicating reduced impairment, activity limitation and improved quality of life also in these patients. Larger studies are needed to increase understanding of the effects of exercise in patients with active, recent-onset polymyositis and DM as well as in patients with IBM and juvenile DM.

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Functional and Structural Adaptations of Skeletal Muscle in Long‐Term Juvenile Dermatomyositis: A Controlled Cross‐Sectional Study

Berntsen

Raastad

Marstein

et al. 2020

Arthritis & Rheumatology

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Objective. To compare muscle strength and endurance of the knee extensors between patients with long-term juvenile dermatomyositis (DM) and controls and between patients with active disease and those with inactive disease, and to explore associations between strength/endurance and 1) clinical parameters, 2) physical activity, and 3) humoral/structural adaptation in the skeletal muscle of patients.Methods. In a cross-sectional study (44 patients and 44 age-and sex-matched controls), we tested isometric muscle strength (peak torque, in Nm) and dynamic muscle endurance (total work, in Joules) of the knee extensors, physical activity (measured by accelerometer), and serum myokine levels (by enzyme-linked immunosorbent assay). Patients were examined with validated tools (clinical muscle tests and measures of disease activity/damage and inactive disease) and using magnetic resonance imaging of the thigh muscles, which included evaluation of the quadriceps cross-sectional area (CSA). Needle biopsy samples of the vastus lateralis muscle (obtained from 12 patients ages ≥18 years) were assessed by histochemistry.Results. After a mean ± SD disease duration of 21.8 ± 11.8 years, peak torque was lower in patients with juvenile DM compared to controls (mean difference 29 Nm, 95% confidence interval 13-46; P = 0.001). Similarly, total work of the knee extensors was lower in patients compared to controls (median 738J [interquartile range 565-1,155] versus 1,249J [interquartile range 815-1,665]; P < 0.001). Both peak torque and total work were lower in patients with active juvenile DM compared to those with inactive disease (both P < 0.019); in analyses controlled for quadriceps CSA, only total work remained lower in patients with active disease. Moreover, peak torque and total work correlated with findings from clinical muscle tests in patients with active disease (r = 0.57-0.84). Muscle biopsy results indicated that the fiber type composition was different, but capillary density was similar, between patients with active disease and those with inactive disease.Conclusion. In patients with long-term juvenile DM, both muscle strength and endurance of the knee extensors were lower when compared to matched controls, and also lower in patients with active disease compared to those with inactive disease. Our results indicate a need for more sensitive muscle tests in this clinical setting. We hypothesize that impaired muscle endurance in patients with active juvenile DM may be influenced by structural/functional adaptations of muscle tissue independent of muscle size.

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Near‐infrared spectroscopy during exercise and recovery in children with juvenile dermatomyositis

Abstract: The results suggest that children with JDM may experience difficulties in increasing muscle blood volume with more strenuous exercise.

Cited by 13 publications

References 31 publications

Exercise oxidative skeletal muscle metabolism in adolescents with cystic fibrosis

Exercise oxidative skeletal muscle metabolism in adolescents with cystic fibrosis

Physical exercise as a treatment for adult and juvenile myositis

Functional and Structural Adaptations of Skeletal Muscle in Long‐Term Juvenile Dermatomyositis: A Controlled Cross‐Sectional Study

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